Donna Jean Destaso
Individual provider Active NPI Physician Assistant · Englewood Cliffs, NJ
NPI 1194333534 · NPPES record last updated Dec 26, 2023
Key facts
- NPI
- 1194333534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 25MP00579800 (NJ)
- Practice address
- 910 Sylvan Ave Ste 100
Englewood Cliffs, NJ 07632-3308 - Phone
- (201) 569-2770
- NPI assigned
- Jul 22, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SBH Physicians PC
Practice addresses (Care Compare)
111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 960-6205
4422 3Rd Ave
Bronx, NY 10457-2545
Phone (718) 960-6214
4487 3Rd Ave
Bronx, NY 10457-1526
Phone (718) 960-6392
Hospital & facility affiliations
- St Barnabas Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.09 of 100
- Quality
- 86.89
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201012000743 | NY | Practitioner - Physician Assistant | 3173943289 | Reassigns benefits to 1 organization |
| I20231212002516 | NJ | Practitioner - Physician Assistant | 3173943289 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00579800 | NJ | MD | Physician Assistant |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gianna Scaglione PA-C LLC | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- ddestaso18888@sbhny.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00579800 | NJ | Yes |
Addresses
Primary practice location
910 Sylvan Ave Ste 100
Englewood Cliffs, NJ 07632-3308
Mailing address
302 Hopper CT
Franklin Lakes, NJ 07417-1143
Phone (201) 805-3763
Other practice location 1
4422 3rd Ave
Bronx, NY 10457-2545
Phone (201) 805-3763
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0947954 | Medicaid | NJ |
Other providers in Englewood Cliffs, NJ
- Naomi De Pompeo
- Krishni De Thabrew
- Maya De Thabrew
- Deanne Confalone DMD PC
- Dentiq of Englewood Cliffs
- You Guang Ding
- Melanie Diniz
- Joseph Disilvio
- Doctor Gong Internal Medicine Clinic
- Dr Isaac Lee Pain & Injection Clinic
All providers in Englewood Cliffs, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.